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General NPI Number Information
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NPI Number | 1528344728
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Entity Type | Individual
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Provider Name | TRISTAN SADOWSKI PHARMD
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Gender | Male
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Dates
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Enumeration Date | 11/01/2011
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Last Update Date | 11/01/2011
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Provider Practice Location Address
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Address Line | 1751 TINY TOWN ROAD
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City | CLARKSVILLE
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State | TN
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Zip | 37040
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Country | US
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Telephone | 931-552-7464
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Fax | 931-552-4204
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Provider Business Mailing Address
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Address Line | 1751 TINY TOWN ROAD
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City | CLARKSVILLE
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State | TN
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Zip | 37040
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Country | US
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Telephone | 931-552-7464
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Fax | 931-552-4204
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 29521
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP441833
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License Number State | PA
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